Untreated Hepatitis C infection is Associated with Decreased Health-Related Quality of Life in Patients Receiving Methadone
The vast majority of patients entering methadone treatment for opioid dependence have hepatitis C virus (HCV) infection. Despite the effectiveness of HCV treatment with pegylated interferon and ribavirin, a minority of patients undergo this treatment. In addition to adverse health consequences (e.g., cirrhosis and hepatocellular cancer), HCV infection is associated with somatic complaints and decreased quality of life (QOL). Investigators sought to determine the impact of untreated HCV infection on health-related QOL among 100 patients receiving methadone maintenance. Primary findings were as follows:
- Health-related QOL scores among patients with untreated HCV infection receiving methadone were significantly lower than scores for the general population and were also lower than scores among patients with untreated HCV who were not receiving methadone.
- The severity of depression among patients was associated with health-related QOL.
There are a number of benefits of HCV treatment, including decreased risk for cirrhosis and hepatocellular carcinoma. The current study adds poor health-related QOL to the potential adverse impact of HCV infection on patients with opioid dependence receiving methadone. Studies that conduct serial assessments of health-related QOL in patients receiving methadone and HCV treatment are needed. In the meantime, physicians caring for patients receiving methadone should stress the potential improvements to health-related QOL and hepatic outcomes when discussing HCV treatment.David A. Fiellin, MD